A Puzzle

I found out last night that I was denied health insurance (Medicaid) because my income was too high. I don't know by how much, but it might be that my rent is too low. (ie because I knew I coundn't afford my own place I moved in with a roommate who is doing me a huge favor by not charging me much rent, therefore my expense to income ratio doesn't fit their formula. Funny, I call this being responsible.). I also don't know what the appeals process looks like, nor do I know if I might have been approved if I already *had* a diagnosis...if I had a piece of paper saying I'm sick and need medical coverage, maybe they would have approved it.

1. My Dr who suspects chronic fatigue syndrome (I agree) can't order more diagnostic tests because I can't afford to pay cash for them and I have no insurance coverage.

2. I have been denied coverage which I need in order to see a Dr, gets tests done, and get an official diagnosis.

3. Its likely that if I had a Dx and a recognition of my 'partial' inability to work that I would be approved for coverage.

4. I have found the Adult MercyCare Clinic through St Joe's Hospital that IF I am approved (they require a denial of Medicaid and proof of low income) will cover with a yearly charge that needs paying upfront (not monthly) on a 3-tier scale of about $350-600 *basic medical care ONLY* this means I could get routine labs, but not specialized diagnostic labs, PAP/pelvic exams which is good, and X-ray only no other diagnostic scans like CAT or MRI (which I need) and low cost Rx, which I already get. So basic preventative/screening level care, but not anything that will get me closer to a Dx. :(

5. Because I am working so little partially bacause of classes but mostly because I'm not up to it, the cost of the above coverage may be out of my budget until I get loan $ in Sept.

6. As a student at MCC I can get subsidized coverage for approximately $1300+ a year, that cannot be paid monthly, and can only opt in at certain times of the year. The deadline for opt in in the fall semester appears to be *before* I'd receive a disbursement. Thereby rendering it about useless.

7. IF I could get onto this plan by perhaps borrowing the $ for a couple weeks...I'd still have all the copays and weirdly graded coverage that comes with a subsidized plan. Meaning, it's not clear until I can get through the fine print what will actually be covered and if it will help with a Dx.

8. If I persue a Dx by appealing AHCCCS or through the MercyCare plan, it will be considered a pre-existing condition per the student coverage. As will Celiac Disease.

9. I checked the cost for purchasing a private plan through Cigna, which is the only plan my current Dr accepts, and the deductible to monthly fee ratio plus copay scenario makes it completely infeasible. Perhaps another company will be different, but I'm guessing they will be within a similar competitive range.

So if you followed all that...you probably agree that I'm sortof f*cked.

I need help, and there's GOT to be an answer. Help, please, Goddess. I know I'll receive what I need, I have faith in that. But right now I don't see how.

And so I will keep looking, keep talking to people in case there's something I haven't thought of, breathe, build patience. And wait.

Sent from my Verizon Wireless BlackBerry